Lessons learned from 500 cases of lymphatic mapping for breast cancer Journal Article
| Authors: | Hill, A. D. K.; Tran, K. N.; Akhurst, T.; Yeung, H.; Yeh, S. D. J.; Rosen, P. P.; Borgen, P. I.; Cody, H. S. 3rd |
| Article Title: | Lessons learned from 500 cases of lymphatic mapping for breast cancer |
| Abstract: | Objective: To evaluate the factors affecting the identification and accuracy of the sentinel node in breast cancer in a single institutional experience. Summary Background Data: Few of the many published feasibility studies of lymphatic mapping for breast cancer have adequate numbers to assess in detail the factors affecting failed and falsely negative mapping procedures. Methods: Five hundred consecutive sentinel lymph node biopsies were performed using isosulfan blue dye and technetium-labeled sulfur colloid. A planned conventional axillary dissection was performed in 104 cases. Results: Sentinel nodes were identified in 458 of 492 (92%) evaluable cases. The mean number of sentinel nodes removed was 2.1. The sentinel node was successfully identified by blue dye in 80% (393/492), by isotope in 85% (419/492), and by the combination of blue dye and isotope in 93% (458/492) of patients. Success in locating the sentinel node was unrelated to tumor size, type, location, or multicentricity; the presence of lymphovascular invasion; histologic or nuclear grade; or a previous surgical biopsy. The false- negative rate of 10.6% (5/47) was calculated using only those 104 cases where a conventional axillary dissection was planned before surgery. Conclusions: Sentinel node biopsy in patients with early breast cancer is a safe and effective alternative to routine axillary dissection for patients with negative nodes. Because of a small but definite rate of false-negative results, this procedure is most valuable in patients with a low risk of axillary nodal metastases. Both blue dye and radioisotope should be used to maximize the yield and accuracy of successful localizations. |
| Keywords: | adult; human tissue; aged; aged, 80 and over; middle aged; major clinical study; cancer localization; cancer diagnosis; lymph nodes; lymphatic metastasis; isosulfan blue; diagnostic accuracy; lymphoscintigraphy; prospective studies; rosaniline dyes; reproducibility of results; breast cancer; breast neoplasms; biopsy; diagnostic value; false negative reactions; lymph node biopsy; technetium sulfur colloid tc 99m; humans; human; male; female; priority journal; article |
| Journal Title: | Annals of Surgery |
| Volume: | 229 |
| Issue: | 4 |
| ISSN: | 0003-4932 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 1999-04-01 |
| Start Page: | 528 |
| End Page: | 535 |
| Language: | English |
| DOI: | 10.1097/00000658-199904000-00012 |
| PUBMED: | 10203086 |
| PROVIDER: | scopus |
| PMCID: | PMC1191739 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 16 August 2016 -- Source: Scopus |
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